The standardized-taper root canal preparation--Part 4. GT file technique in large root canals with large apical diameters.

AIM

To describe the GT file shaping steps required to create apical resistance in the presence of a wide root apex.

SUMMARY

Canals are occasionally encountered with apices wider than 0.25 mm. These can be some of the most difficult to manage with conventional instruments, and overfills are common. Shaping such canals with GT files requires a paradigm shift of thinking, extending tapered files through the apex to create linear resistance in the apical few mm of the canal. GT standard and accessory files allow canals with apices up to around 0.7 mm to be prepared for tapered gutta percha cone-fit. Apices larger than this should be considered too large for further shaping, and repaired with MTA before filling.

KEY LEARNING POINTS

Tapered apical preparations offer optimal resistance form for obturation. Tapered apical preparations can be prepared in most roots with wide apices by extending GT files and GT accessory files to or through the apex. Apices wider than 0.7 mm should be repaired with MTA prior to filling.